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目的 :了解我国输血后丙型肝炎病毒 (HCV)感染的慢性化规律和影响因素。方法 :对河北省固安县某农村 137例单采浆献血员HCV感染 12～ 2 5年的现状进行调查 ,包括临床表现 ,血清丙氨酸氨基转移酶 (ALT)、天门冬氨酸氨基转移酶 (AST)、γ 谷氨酰转肽酶 (γ GT)、碱性磷酸酶 (ALP)、血清总胆红素 (TBil)、直接胆红素 (DBil)、总蛋白(TP)、白蛋白 (ALB)测定和αFP检测 ,病毒学标志检测以及B型超声检查 ,其中 ,HCVRNA的测定采用荧光定量PCR方法 ,抗 HCV和HBsAg测定采用酶联免疫吸附试验。结果 :该组HCV感染的慢性化率为 70 .99% ,自然阴转率为2 9 .0 1%。 137例感染者目前几乎均无症状 ,总的ALT和 /或AST异常率为 37.4 0 % ,6例为中度 ,其余均为轻度 ,无重度。但B型超声检查发现 ,轻度者占 5 7.72 % ,中度占 38.2 1% ,重度占 4 .0 7%。重度者距感染发生时间分别为 13、14、2 1、2 5和 2 5年。HCVRNA阳性组的ALT、AST和γ GT平均水平显著高于阴性组 ,抗 HCV阳性组的ALT/AST的异常率显著高于阴性组 ,抗 HCV滴度与HCVRNA水平的对数呈正相关 (r=0 .74 7,P <0 .0 1)。男性感染者的慢性化率高于女性感染者 (78.6 9%比 6 4 .2 9% )。结论 :本组输血后HCV感染自然阴转率较高 ,慢性HCV感染表现隐匿 ,肝酶学检查指标?
Objective: To understand the chronicity and influencing factors of hepatitis C virus (HCV) infection after transfusion in China. Methods: A total of 137 cases of single-donor blood donors from a rural area in Gu’an county of Hebei Province for 12 ~ 25 years were investigated. The clinical manifestations included serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-GT, ALP, TBil, DBil, TP, albumin ALB), αFP, virological markers and B-mode ultrasonography. HCVRNA was detected by fluorescence quantitative PCR, and anti-HCV and HBsAg were tested by enzyme-linked immunosorbent assay (ELISA). Results: The chronic infection rate of HCV infection in this group was 70.99% and the rate of natural negative conversion was 29.0%. The 137 infected persons were almost asymptomatic at present with an overall abnormal rate of ALT and / or AST of 37.4%, 6 moderate and the rest mild and non-severe. However, B-mode ultrasound showed that 5 7.72% were mild, 38.2 1% moderate, and 4.70% were severe. Severe infection from the time were 13,14,2 1,2 5 and 25 years. The average level of ALT, AST and γ GT in HCV RNA positive group was significantly higher than that in negative group, and the abnormal ALT / AST rate in anti HCV positive group was significantly higher than that in negative group. The anti-HCV titer was positively correlated with the logarithm of HCV RNA level (r = 0 .74 7, P <0 .0 1). The rate of chronic infection among men infected was higher than that among women (78.6 9% vs. 6.42%). Conclusion: The natural infection rate of HCV infection after transfusion in this group is high, the performance of chronic HCV infection is insidious, and the index of liver enzymology examination?